This invention relates to patient carrier devices, and more specifically to a wheeled dolly for use with patient carrier devices such as backboards that are used in the evacuation of patients needing medical attention.
Paramedics and other emergency medical personnel routinely use patient carrier devices to evacuate injured patients. There are many different kinds of patient carriers, including numerous styles of backboards and extrication cots, and they are available from many commercial sources, in many different shapes and styles. Almost all such devices include a variety of straps that are used to secure the patient in place on a patient-carrying platform. With reference to a typical xe2x80x9cbackboard,xe2x80x9d in a typical emergency patient evacuation the injured patient is strapped to the platform defined by the backboard in a manner appropriate for the patient""s particular medical condition. Often the patient is either not ambulatory or the patient""s medical condition necessitates careful movement of the patientxe2x80x94hence the backboard serves as a platform on which the patient is immobilized while being transported to a remote location, for instance an ambulance or a triage location.
As a first step in patient evacuation, when a patient is ready to be moved the patient must be adequately immobilized on the backboard. This is typically accomplished with the patient in a supine position. In most cases at least four medical personnel are required to transport an injured patient secured to a backboard. In some cases more than four personnel are needed. One of the team is positioned at each of the four corners of the backboard. Each of the four personnel carefully lifts the backboard to raise the patient. The fully loaded backboard must then be carefully transported to a safe location. Transporting the patient often requires careful maneuvering. For instance, moving an injured patient through a typical house often presents difficult situations, such as maneuvering around tight corners, and going up or down stairs. This kind of maneuvering is difficult enough when transporting inanimate objects such as furniture. But when it is an injured patient that is being transported, the difficulties encountered in transporting the patient become far greater.
Other evacuation scenarios present even more difficult problems. To identify just a few of the difficult situations faced everyday by paramedics, consider the example of a victim who, because of his or her location in a dangerous or potentially dangerous situation, must be transported quite rapidlyxe2x80x94the victim of a fire who is unable to move on their own is a good example. The need to move the victim quickly out of harm""s way greatly compounds the difficulties faced by the paramedics. As another example, many automobile accidents involve xe2x80x9cover the sidexe2x80x9d situations where in an accident the automobile has gone over an embankment. Often this occurs in difficult terrain. Getting an injured victim out of this kind of a precarious situation often mandates that a team of more than four personnel are needed to move the patient on the backboard. An over the side accident even often necessitates a system of ropes, pulleys and winches to pull the backboard up the embankment slope. When several paramedics are carrying the backboard it is easy to understand the difficulties the paramedics face in attempting to minimize patient disruption during even relatively simple evacuations.
Another graphic example is the situation where a victim is located in a bedroom having a narrow doorway, and/or a house having narrow hallways. Many structures existing today have narrow doorways and corridors. Transporting a patient through such restricted passages can be very difficult, especially where the patient""s medical condition mandates extremely careful patient handling. When a backboard requires a team of four paramedics to carry the patient, maneuvering the backboard and the patient is very difficult.
As a final example of the difficulties emergency medical personnel encounter when transporting injured patients, it is of course obvious that extreme care must be taken to transport a patient having a potential spinal injury. Even in a relatively straightforward evacuation where no great obstacles are encountered, paramedics must exercise the utmost caution when transporting the patient. This can make the paramedic""s job very difficult in even the most routine transportation of victims of spinal injuries. When the evacuation scenario is more difficult, as is often the case, the difficulties of the paramedics"" job is compounded.
Patient transport is not the only function of patient carrier devices such as backboards. Often a victim is located remotely from the nearest vehicular access. This occurs, for instance, where a hiker or climber has been injured in a remote location that is not accessible to emergency vehicles. In that case, paramedics may need to carry emergency medical equipment such as jump bags, oxygen canisters and even cardiac monitoring equipment a long distance to the victim. Many paramedics use backboards as a platform onto which such equipment may be loaded and secured. Of course, more than one person is needed to carry a heavy load. But the backboard nonetheless provides a convenient method of transporting the equipment.
As may be derived from the discussion above, patient transport on patient carrier devices is often a difficult and dangerous operation. The difficulties encountered with even the most routine patient moves are compounded when the victim is located in a dangerous or restricted area, or where the patient""s medical condition presents special concerns, for instance where the patient is unconscious and unable to assist in the move, or where the injury mandates special patient treatment. Nonetheless, patient carrier devices are used ubiquitously in the emergency medical field. Such devices are used everywhere from civilian medical evacuations to military evacuationsxe2x80x94they are used wherever there is a need to transport the injured, and they make the paramedics"" job much easier and the offer significant improvements in patient care.
But despite their everyday usefulness in securing injured patients and their role in transporting the patient, patient carrier devices ironically cause many problems, including injuries to both the patient and to the team of emergency personnel transporting the patient. For example, many, many emergency medical personnel are injured every year while patients are being transported on carrier devices. Back, shoulder and other injuries are common among paramedics caused by lifting patients who are secured to backboards. Sometimes the patients are simply so heavy that even a team of four paramedics has trouble lifting the patient, creating great lifting strain on the team members. These problems are compounded where the patient is in a difficult environment that necessitates lifting in other than ideal lifting positions, and when the patient must be moved in a low-angle evacuation.
Thus, there is a need for a patient carrier device system that is ergonomically designed to consider both the needs of the patients and the paramedics who transport them. As noted, in some situations the patient must be evacuated with haste. This is the case, for instance, in a tactical response type of emergency where it is necessary to get victims out of a dangerous situation very quickly. Standard carrier devices such as backboards make this job difficult, since at least four people are needed to carry the device when a patient is strapped to it. This also puts four medical personnel in a dangerous situation while the victim is being loaded onto the backboard and during transportation to a safe location.
Thus, there is a very real need for a patient carrier device that addresses the needs of both medical personnel and patients. The present invention addresses these needs by providing a wheeled dolly that is adapted for use with almost every patient carrier device available on the market today, from all types of backboards to extrication cot devices. The invention converts a standard carrier device such as a backboard into a rapid deployment and evacuation system for injury victims. The wheeled dolly has a box frame that accepts the carrier device and secures it into place in the box frame to thereby provide a two-wheeled platform on which to transport the victim. Handles are optionally provided with universal attachments for rapid connection with any backboard or carrier device. With the combination of the dolly and the optional handles, the patient carrier may be transported through even the most difficult locations and terrain. Moreover, the use of a wheeled dolly allows even heavy and/or severely injured patients to be reliably transported by fewer personnel than is required when the present invention is not employed. Various types of wheels may be mounted onto an axle to meet the needs of the varying conditions where victims may be located. With the appropriate wheels in place, the injured patient may be moved around corners and through doorways that would be all but impassible with the carrier device alone. Even heavy equipment may be strapped to the wheeled system and moved by a single paramedic. The risk of injuries to the paramedicsxe2x80x94especially back and shoulder injuriesxe2x80x94is greatly reduced since the dolly reduces the effective load weight that the paramedic must heft.